20210735 Ver 1_Shoreline Stabilization_20210513

Shoreline Stabilization Application Form
15ANCAC 02H .0500 — Water QualityCertification, Shoreline Stabilization
FORM SSGP 10-2013
DRAFT -NOT FOR USE AT THIS TINE
Submission Form
Pre -Filing Meeting Information
Before submitting this form please ensure you have submitted the Pre -Filing Meeting Request Form as we will not be able
to accept your application without this important first step. The Pre -Filing Meeting Request Form is used in accordance
with 40 C.F.R. Section 121.4(a) "At least 30 days prior to submitting a certification request, the project proponent shall
request a pre -filing meeting with the certifying agency" and in accordance with 40 C.F.R. Section 121.5(b)(7), and (c)(5)
all certification requests shall include documentation that a pre -filing meeting request was submitted to the certifying
authority at least 30 days prior to submitting the certification request. Click here to read more information on when this
form is needed prior to application submission or here to view the form.
Attach documentation of Pre -Filing Meeting Request here:
Pre -Submittal Meeting Request Form.pdf 1.22MB
Pre -fling Meeting or Request Date 4/10/2021
ID# 20210735
I. Applicant Information [15A NCAC 02H .0502(a)]
Version 1
Please note: fields marked with a red asterisk * below are required. You will not be able to submit the form until all
mandatory questions are answered.
Primary Contact Email *
Owner Information:
Name:*
Email:
*
Phone Number:*
Mailing Address:*
[e-mail]
Rease provide an email address for payrrent and requests for pore information here.
Pete Bowen
[e-mail]
[phone]
(xxx)xxx-xxxx
Street Address
307 Windemere Isle Road
Address Line 2
CitY
Statesville
Rbstal / Zip Code
28677-2077
State / Rovince / Region
NC
Country
US

Is there an agent working on the
project? *
Agent/Consultant Information
.......................................................................................................
Name:*
Company Affiliation: *
Email:*
Phone Number:*
• Yes
✓ No
Janice Estep
CBC Stone & Recycling, LLC
[e-mail]
[phone]
(x)m-
Mailing Address:* Street Address
638 Oakridge Farm Hwy
Address Line 2
City State / Province / Legion
Mooresville NC
Fbstal / Zip Code Country
28115 United States
Asigned and dated copy of the Agent Authorization letter:*
Auth. Form.pdf 1.14MB
Link to: Sample Agent Authorization Form
Project Information [15A NCAC 02H .0502(a) & (b)]
Project Name:*
Bowen Shoreline
If your project has a formal name please use this. If your project does not have a formal name, please identify your project by
the owner name and proposed activity (Jones Property Access Road, Smith Guest House, etc.) List in parentheses any
other names that have been used to identify the project in the past.
1. Provide a vicinity map (i.e. street map) clearly showing the location of the property with respect
to local landmarks such as towns, rivers, and roads.*
✓ Upload File
✓ Look up address
Upload Map:
Latitude:*
Plat Map.pdf 1.55MB
Vicinity Maps.pdf 6.9MB
Directions.pdf 805.731(B
35.664423
Longitude:* -80.961915
2. Provide a detailed site plan showing property boundaries and proposed locations of vegetation clearing,
structures (buildings, retaining walls, docks, impervious surfaces, etc.), rip rap, excavation or dredging
below Full Pond/ Normal Water Level elevations, and construction access corridors. You may use the
diagram under section 12.normal pool lake level/normal water level*
Site Plan.pdf
Buffer Form.pdf
Please use the diagram at the link below:
1.11MB
1.53MB
https://edocs.deq.nc.gov/WaterResources/0/edoc/616616/Shoreline%20Layout.docx

3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of some sort- a
yard stick, shovel handle, etc.)*
Shoreline Pics.pdf 6.03MB
4. Location of the property (where work is to be conducted)
Nearest Town:*
County: *
Lake/ river/ ocean adjacent to
property:
Statesville
Iredell
Norman
Subdivisions name or site address:* 307 Windemere Isle Dr. Statesville, NC 28677 Lot 6 Windemere Isle
hclude phase/lot nunber
Directions to site:*

610 E Center Ave
Mooresville, NC 28115
Head south on Evergreen St toward E Center Ave
20 s (197 ft)
Take NC-115 N, Cornelius Rd and Perth Rd to Hicks Creek Rd
20 min (11.6 mi)
Turn right onto E Center Ave
0.5 mi
Turn right onto N Church St
0.2 mi
Turn left onto E Iredell Ave
0.1 mi
Turn right onto NC-115 N/N Broad St
Continue to follow NC-115 N
2.1 mi
Turn left onto Connector Rd
0.8 mi
Continue onto Cornelius Rd
2.4 mi
Turn right onto Judas Rd
1.2 mi
Turn right onto Perth Rd
3.0 mi
Turn left onto State Park Rd
1.1 mi
Follow Hicks Creek Rd to E Monbo Rd
3 min (2.0 mi)
Sharp left onto E Monbo Rd
3 min (2.1 mi)
Follow E Monbo Rd to Windemere Isle Rd
3 min (1.4 mi)
Slight left to stay on E Monbo Rd
0.6 mi
Turn left onto 3100/Heronwood Rd
0.1 mi
Continue straight onto Windemere Isle Rd
Destination will be on the left
0.7 mi
307 Windemere Isle Rd
Statesville, NC 28677
Rease include road mires and nurrbers, landrrarks etc.
5. Describe the existing land use or condition of the site at the time of this application:*

Residential
Fssidential, undeveloped, etc.
6. Property Size 0.52 acres
Acres
7. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Shape and slope shoreline, install matting and VA Fieldstone boulder rip
rap and install TN Crab Orchard steps, remove small undermined trees on
immediate shoreline to properly stabilize.
8. How will the work be done?*
r From Land
17. From Water
9. Total amount of disturbance below the normal pool lake level/ normal water level:*
(including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
2' below (228 sf)
square feet
10. Total amount of disturbance above the normal pool lake level/ normal water level and 50 feet
land -ward: *
(including all clearing, back fill, excavation, rip rap, retaining walls, etc.)
1' above (114 sf)
square feet
11. Please describe the vegetation above the normal pool lake level/ normal water level and 50 feet
landward to be impacted:*
(nurrber of trees, for instance)
Grass buffer, remove only small undermined trees on immediate shoreline
to properly stabilize, no disturbance to buffer
Sketch:
Application Fee:
Once the application has been accepted. You will need to send a corresponding fee in with the appropriate DWR#. The
application fee is as follows (pursuant to G.S. 143-215.3D):
o $240.00 for impacts to lake (below normal water level) of less than 1 acre
o $570.00 for impacts to lake (below normal water level) of greater or equal to 1 acre
By digitally signing below, I certify that:
o I, the project proponent, hereby certifies that all information contained herein is true, accurate, and complete to the
best of my knowledge and belief
o I, the project proponent, hereby requests that the certifying authority review and take action on this CWA 401
certification request within the applicable reasonable period of time.
o I agree that submission of this Shoreline Stabilization online form is a "transaction" subject to Chapter 66, Article 40 of
the NC General Statutes (the "Uniform Electronic Transactions Act");
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act");
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
o I intend to electronically sign and submit the Shoreline Stabilization online form.
Full Name:*
Signature:
Janice Estep

Initial Review
Is this accepted into the review fr Yes 0 No
process?*
Project Number:* 20210735
Select Reviewer:*
Select Reviewing Office:
Has payment been received?*
What amount is owed?*
Version:* 1
Alan Johnson:eads\adjohnsonl
Mooresville Regional Office - [phone]
r No Payment Needed
r Fee Received
C' Need Fee - send electronic notification
C' $240.00
r $570.00

AGENT A ZA ION
PROPERTY LEGAL DESCRIPTION:
LOT NO.
•STREET ADDRESS:
• PLAN NO. PARCEL
e tie
Please print:
Property Oner:
Property Owner:
AMISPI.PMPROMMinainklIFIVOINIPOPIP1111,411.1.ppowl
The undersigned, registered property owners of the above noted property, do hereby authorize
a°."0420 qk ce
(Contractor / Agent)
‘
e E )
(Name of consulting
to ad: on my behalf and take all actions necessary for the processing, issuance• and acceptance of
this permit or certification and any and all standard and special conditions attached.
Prop Owner's Address (if different than property above):
Telephone: C..)14_7 et - 'a 2.
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
PPPPIPIPM411101141M1011441
•Authorized Sig
Date:
Authorized Signature
Date:
g'''PIPPPPIRM41.1111,111111011410.111MPOPPIONININNONIpppprnelmmedigmem................

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Please approximately sketch the following information on this plan, length of shoreline
(provide dimensions for each item, such as 10 ft x 100 ft) *:
1. Alt proposed vegetation clearing
Z. Location of rip rap or fill to be placed above the Full Pond/ Normal Water Level elevation
3. Location of rip rap or fill to be placed below the Full Pond/ Normal Water Levet elevation
4. Location of any proposed structures such as buildings, retaining wails, docks, etc.
5. location of any excavation or dredging below the Full Porid/ Norma! Water Level elevation
6. Location of construction access corridors
FORM: SSGP 10-2013 Page 3 of 3

-
Project Name/address:
WBA RIPAR BUFFE
Owner: iDedi EP' ?)01‘)ED--1\1
Print
Contractor/agent: C Skun
Print
Xounty;
Th approval is for the .purpose and design described in.. your application. Impacts not indicatd in the
application is avioiatiOtt.Of the Buffer Rule. Site specific work should be provided in the .application* [15A. NCAC
02H #0506 and 15A NCAC 02B .0243(8)3
Trees are not allowed to be removed from Zone 1 of the Buffer (within 30 ft of the full pond elevation), unless
approved. Exception, those trees that are severely undermined along the inunediate shoreline can be remo
inimal shaping and sloping along the immediate shoreline is allowed. [15A NCAC 02B40243(6)]
Benching, grading in the buffer is not allowed. Excessive disturbance aground cover. [15A NCAC 0213.0243 (6)1
Beaches, impervious patios, impervious walkways, etc. are not allowed in the buffer unless specifically approved
by the Division. There are limitation on size for decks.. [15A NCAC 028 .0243(4) and (6)3
Work to be conducted from land must indicate an access and indicate any trees that are to be removed. The
work corridor should be described_ The approved access corridor shall be restored. Staging, spoil, construction
material must be outside the buffer. [15A NCAC 02H .0502 and 15A NCAC 0213 .0243 Oh (6), (8)1
Stormwater cannot be piped or channeled for direct discharge to the take. All constructed storrnwater
discharges must be at the natural elevation and discharged prior to entering the buffer directed as diffuse or
sheet flow at non -erosive velocities to the lake. [15A NCAC 02B .0243(5), (6)}
Acknowledgement of Notification
hereby state that I have been informed of the Catawba
Riparian Buffer Rule. Any: work conducted in the buffer, not specifically stated in the application and approved
by the Division of Water Resources (DWR), is a violation and subject to enforcement. Due diligence will be
taken such that the construction will be built within substantial compliance and intent. of the 401 Water
Quality Certification and Buffer Rules, the approved plan(s) and specification(s), and other supporting
mterials...
gnature (owner
Date:

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DWR Pre -Filing Meeting Request .Form
ID#*
Regional Office
*
Reviewer List*
20210735
Version*
1
Mooresville Regor Office - (704) 6631699
Alan Johnson
Pre -Filing Meeting Request submitted 4/1012021
Contact Name * Janice Estep
Contact Email Address* [e-mail]
Project Name* Bowen ShoreUne
Project Owner* Pete Bowen
Project County* Iredelt
Owner Address: Street Address
307 Windemere Isle Rd.
Address Line 2
City State / Rrovince I Fdegian
Statesville NC
Rasta] i zip coax Country
28677 Unified States
Is this a transportation pr j Yes No
Type(s) of approval sought from the DWR:
r 401 Water �uality Certification - r 401 Water Quality Certification
Regular Express
r individual Permit r Modification
i4 Shoreline Stabilization
Does this project have an existing project ID#? *
Yes . • No
Do you know the name of the staff member you would like to request a meeting with?
Alan Johnson
Please give a brief project description below and include location information.*
Shape and slope shoreline, instaH matting and install VA Fieldstone
boulder rip rap for new shoreline stabilization. Remove only small
trees on immediate shoreline to properly stabilize. Install TN Crab
orchard steps. Project by barge.
Please give a couple of dates you are available for a meeting.

4112/2021
4/1 3/2021
4/14/2021
4/15/2021
4116/2021
Please attach the documentation you would like to have the meeting about.
Bowen Shoreline.pdf
1.79MB
By digitally signing below, I certify that I have read and understood that per the Federal Clean Water Act Section
401 Certification Rule the following statements:
This form completes the requirement of the Pre -Filing Meeting Request in the Clean Water Act Section 401 Certification
Rule.
I understand by signing this form that [ cannot submit my application until 30 calendar days after this pre -fling
meeting request.
• � also understand that DWR is not required to respond or grant the meeting request.
Your projecVs thirty -day clock started upon receipt of this application. You will receive notification regarding meeting location
and time if a meeting is necessary. You will receive notification when the thirty -day clock has expired, and you can submit an
application.
Signature
637aoreireerce..ki-Tr(lo
Submittal Date 4/10/2021